Bouts of coughing or wheezing that get worse with a respiratory infection, such as a cold or the flu

Delayed recovery or bronchitis after a respiratory infection

Trouble breathing that may limit play or exercise

Fatigue, which can be caused by poor sleep

The first signs of asthma in young children may be recurrent wheezing triggered by a respiratory virus. As children grow older, asthma associated with respiratory allergies is more common.

Asthma signs and symptoms vary from child to child, and may get worse or better over time. Your child may have only one sign or symptom, such as a lingering cough or chest congestion.

It may be difficult to tell whether your child's symptoms are caused by asthma or something else. Periodic or long-lasting wheezing and other asthma-like symptoms may be caused by infectious bronchitis or another respiratory problem.

When to see a doctor

Take your child to see the doctor as soon as possible if you suspect he or she may have asthma. Early treatment will not only help control day-to-day asthma symptoms, but also may prevent asthma attacks.

Make an appointment with your child's doctor if you notice:

Coughing that's constant, intermittent or seems to be linked to physical activity

Wheezing or whistling sounds when your child exhales

Shortness of breath or rapid breathing

Complaints of chest tightness

Repeated episodes of suspected bronchitis or pneumonia

If your child has asthma, he or she may say such things as, "My chest feels funny" or "I'm always coughing. Listen for bouts of coughing when your child is asleep. This coughing may or may not awaken your child. Crying, laughing, yelling, or strong emotional reactions and stress also may trigger coughing or wheezing.

If your child is diagnosed with asthma, creating an asthma action plan can help you and other caregivers monitor symptoms and know what to do if an asthma attack does occur.

When to seek emergency treatment

In severe cases, you may see your child's chest and sides pulling inward as he or she struggles to breathe. Your child may have an increased heartbeat, sweating and chest pain. Seek emergency care if your child:

Has to stop in midsentence to catch his or her breath

Is using abdominal muscles to breathe

Has widened nostrils when breathing in

Is trying so hard to breathe that the abdomen is sucked under the ribs when he or she breathes in

Even if your child hasn't been diagnosed with asthma, seek medical attention immediately if he or she has trouble breathing. Although episodes of asthma vary in severity, asthma attacks can start with coughing, which progresses to wheezing and labored breathing.

Causes

The underlying causes of childhood asthma aren't fully understood. Developing an overly sensitive immune system generally plays a role. Some factors thought to be involved include:

Inherited traits

Some types of airway infections at a very young age

Exposure to environmental factors, such as cigarette smoke or other air pollution

Increased immune system sensitivity causes the lungs and airways to swell and produce mucus when exposed to certain triggers. Reaction to a trigger may be delayed, making it more difficult to identify the trigger. These triggers vary from child to child and can include:

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